Hepatitis C Virus positivity prediction from serum samples using NIRS and L1-penalized classification.

AIMS: The hepatitis C virus (HCV) has developed a strategy to coexist with its host resulting in varying degrees of tissue and cell damage, which generate different pathological phenotypes, such as varying degrees of fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). However, there is no integrated information that can predict the evolutionary course of the infection. We propose to combine Near-infrared spectroscopy (NIRS) and machine learning techniques to provide a predictive model. In this work, we propose to discriminate HCV positivity in biobank patient serum samples. METHODS: 126 serum samples from 38 HCV patients in different stages of the disease were obtained from the Biobank of Hospital Universitario Fundación Alcorcon. NIRS spectrum was captured by a FT-NIRS Spectrum 100 (Perkin Elmer) device in reflectance mode. For each patient, the HCV positivity was identified (PCR) and labeled as detectable =1 and undetectable =0. We propose an L1-penalized logistic regression model to classify each spectrum as positive (1) or negative (0) for HCV presence (x). The regularization parameter is selected using 5- fold cross-validation. The penalized model will induce sparsity in the solution so that only a few relevant wavelengths will be different from zero. RESULTS: L1-penalized logistic regression model provided 167 wavelengths different from zero. The accuracy on an independent test set was 0.78. CONCLUSIONS: We present a straightforward promising approach to detect HCV positivity from patient serum samples combining NIRS and machine learning techniques. This result is encouraging to predict HCV progression, among other applications. Clinical relevance- We presented a simple while promising approach to use machine learning and NIRS to analyze viral presence on sample serums.

[Changes in quality of life in patients undergoing bariatric surgery following 24-months: comparison between gastric bypass and tubular vertical gastrectomy]. / Evolución de la calidad de vida a los 24 meses de seguimiento en pacientes sometidos a cirugía bariátrica: comparación entre el bypass gástrico y la gastrectomía vertical tubular.

BACKGROUND: Bariatric surgery has become the procedure of choice to deal with morbid and super-morbid obesity, with the greatest chance of success. The objectives of this study were: a) to analyse the evolution of the percentage of excess BMI lost (PEBMIL) and quality of life in the medium and long term after bariatric surgery; b) to evaluate the differences in PEBMIL and quality of life according to the surgical technique performed; and c) examine the relationship between PEBMIL and quality of life. METHODS: One hundred and ninety-one subjects participated in the present study, undergoing bariatric surgery with follow-up at 12 and 24 months after surgery. The SF-36 and OP-53 questionnaires were administered to assess the quality of life after surgery. RESULTS: There was a statistically significant reduction in the percentage of excess BMI lost at 12 and 24 months; and a significant improvement in quality of life at 12 months, which remained stable at 24 months for most variables. Taking into account the surgical technique, those undergoing gastric bypass surgery show a greater loss of PEBMIL at 12 and 24 months, and significant improvement at one year of evaluation in most of the dimensions that measure quality of life with respect to the tubular vertical gastrectomy technique. CONCLUSION: Bariatric surgery is effective in reducing the excess of BMI lost and significantly improving the quality of life of morbidly obese patients in the long term. Key words. Bariatric surgery. Quality of life. Morbid obesity.

Treatment with bisphosphonates in severe hypercalcemia due to subcutaneous fat necrosis in an infant with hypoxic-ischemic encephalopathy.

Subcutaneous fat necrosis (SCFN) is a rare entity that occurs generally in term or post-term newborns exposed to perinatal stressing factors. These cutaneous lesions appear during the first weeks of life and their potential complications, such as hypercalcemia, determine the prognosis. We present a full-term newborn with SCFN lesions that appeared at the age of 12 days and who, 1 week later, developed moderate hypercalcemia. In our patient, the standard treatment was not enough to normalize calcemia and, in order to prevent secondary effects, etidronate therapy was initiated and it successfully normalized calcium levels. When SCFN is diagnosed, it is important to detect early hypercalcemia and treat it aggressively. This case provides further evidence of etidronate as an alternative and effective treatment for moderate-severe hypercalcemia.

Assessing a therapeutic exchange protocol for second-generation antidepressants: clinical results.

OBJECTIVE: To design a therapeutic exchange protocol for antidepressants and clinically assess variables, such as: compliance level, frequency of cases with clinically significant increase on the Udvalg-für-Kliniske-Undersogelser (UKU) psychopharmacological scale, adverse effects analysis, overall analysis of UKU rating development and patients' level of acceptance. Secondary objectives were to correlate psychopharmacological treatment aspects with the pharmacological morbidity level, and evaluate the clinical impact of pharmacotherapeutic optimisation measures. METHOD: The protocol is designed in accordance with a bibliographical review, which was approved by the Pharmacy and Therapeutics Commission. Sequential study was carried out with a sample of 30 patients. Three measurements were taken (base line, at 48-72 hours and at 1-3 weeks) to calculate the pharmacotherapeutic morbidity with the UKU rating scale and the Global Clinical Impression. Pharmacotherapeutic optimisation measures were used for those patients with high pharmacotherapeutic morbidity levels. RESULTS: The compliance level was 73.3%. One patient experienced ≥25% increase on the UKU rating scale and another patient suffered from an adverse effect. The final UKU rating reached statistical significance compared with the measurements taken at 48-72 hours (P=.032) and with the base line measurement (P=.007). Patient acceptance was 90%. The impact of optimisation measurements on the pharmacotherapeutic morbidity level was clinically and statistically significant (P<.001). CONCLUSIONS: The proposed protocol has been widely accepted and it is quite certain that it is to be introduced in at a general hospital level.

Postnatal neurogenesis in the medial cortex of the tropical lizard Tropidurus hispidus.

Young, adult and presumed old specimens of the tropical lizard Tropidurus hispidus, living in an almost steady warm habitat, have been the subjects of a 5-bromodeoxiuridine immunocytochemical study to label proliferating brain cells. All animals showed abundant 5-bromodeoxiuridine-labeled nuclei in the ependyma of their telencephalic lateral ventricles, with these being especially abundant in the medial cortex ependyma. Surprisingly, adult animals displayed higher numbers of labeled nuclei when compared with those of young specimens. In a second experiment, in order to check the evolution of ependymal-labeled nuclei, adult specimens were allowed 4 h or 2, 4, 7, 15 or 30 days of survival after the 5-bromodeoxiuridine pulse. Most labeled nuclei appeared isolated at short survival times (4 h and 2 days after the 5-bromodeoxiuridine pulse) but from day 4 and beyond, labeled nuclei appeared in couples or groups usually located in the ependyma. Labeled nuclei with vertical fusiform appearance in the inner plexiform layer or even recruited in the medial cortex cell layer were assumed to be migratory. These presumed migratory nuclei were unexpectedly few (less than 30%) when compared with other lizards, and they appeared much later; at 15 and 30 days after the pulse. This situation resembles that of mammals where only a small proportion of postnatally generated neurons can develop and survive.